scholarly journals Outcomes of Greater Occipital Nerve Injections in Pediatric Patients With Chronic Primary Headache Disorders

2014 ◽  
Vol 50 (2) ◽  
pp. 135-139 ◽  
Author(s):  
Amy A. Gelfand ◽  
Amanda C. Reider ◽  
Peter J. Goadsby
Keyword(s):  
Pediatric Patients ◽  
Primary Headache ◽  
Headache Disorders ◽  
Occipital Nerve ◽  
Primary Headache Disorders ◽  
Greater Occipital Nerve

scholarly journals Greater Occipital Nerve Stimulation via the Bion® Microstimulator: Implantation Technique and Stimulation Parameters Clinical Trial: NCT00205894

2009 ◽  
Vol 3;12 (3;5) ◽  
pp. 621-628 ◽  
Author(s):  
Terrence L. Trentman
Keyword(s):  
Nerve Stimulation ◽  
Primary Headache ◽  
Implantation Technique ◽  
Headache Disorders ◽  
Occipital Nerve ◽  
Primary Headache Disorders ◽  
Stimulation Parameters ◽  
Greater Occipital Nerve ◽  
The Mean ◽  
One Year

Background: Millions of patients suffer from medically refractory and disabling primary headache disorders. This problem has led to a search for new and innovative treatment modalities, including neuromodulation of the occipital nerves. Objectives: The primary aim of this study is to describe an implantation technique for the Bion® microstimulator and document stimulation parameters and stimulation maps after Bion placement adjacent to the greater occipital nerve. The secondary aim is to document outcome measures one year post-implant. Design: Prospective, observational feasibility study. Methods: Nine patients with medically refractory primary headache disorders participated in this study. Approximately 6 months after Bion insertion, stimulation parameters and maps were documented for all patients. At one year, outcome measures were collected including the Migraine Disability Assessment Score. Results: At 6 months, the mean perception threshold was 0.47 mA, while the mean discomfort threshold was 6.8 mA (stimulation range 0.47 – 6.8 mA). The mean paresthesia threshold was 1.64 mA and the mean usage range was 16.0. There were no major complications reported such as device migration, infection, or erosion. One patient stopped using her Bion before the 12-month follow-up visit. At one year, 7 of the 8 patients were judged as having obtained fair or better results in terms of reduction of disability; 5 patients had greater than a 90% reduction in disability. Limitations: Small, heterogeneous patient population without control group. Not blinded or randomized. Conclusion: The Bion can be successfully inserted adjacent to the greater occipital nerve in an effort to treat refractory primary headache disorders. This microstimulator may provide effective occipital stimulation and headache control while minimizing the risks associated with percutaneous or paddle leads implanted subcutaneously in the occipital region. Key words: Chronic headache, migraine, cluster headache, peripheral nerve stimulation

Functional Connectivity between Trigeminal and Occipital Nerves Revealed by Occipital Nerve Blockade and Nociceptive Blink Reflexes

Cephalalgia ◽  
2006 ◽  
Vol 26 (1) ◽  
pp. 50-55 ◽  
Author(s):  
V Busch ◽  
W Jakob ◽  
T Juergens ◽  
W Schulte-Mattler ◽  
H Kaube ◽  
...  
Keyword(s):  
Pain Perception ◽  
Primary Headache ◽  
Repeated Measurements ◽  
Afferent Pathways ◽  
Nerve Blockade ◽  
Occipital Nerve ◽  
Primary Headache Disorders ◽  
Nociceptive Blink Reflex ◽  
Greater Occipital Nerve ◽  
Neurophysiological Studies

Headache syndromes often suggest occipital and neck involvement, although it is still unknown to what extent branches of segment C1-C3 contribute actively to primary headache. Pain within the occipital area may be referred to the trigeminal territory. However, a modulation of trigeminal transmission by affecting cervical input in humans has not been elucidated so far. A convergence of cervical and trigeminal input at the level of the caudal part of the trigeminal nucleus in the brainstem has been suggested due to anatomical and neurophysiological studies in animals. We examined the R2 components of the nociceptive blink reflex responses in 15 healthy subjects before and after unilateral nerve blockade of the greater occipital nerve with 5 ml prilocain (1%). R2 response areas (AUC) decreased and the R2 latencies increased significantly after the nerve blockade only on the side of injection. AUC and latencies on the non-injection side remained stable. Thresholds for sensory or pain perception did not differ significantly between the repeated measurements on both sides. Our findings extend previous results related to anatomical and functional convergence of trigeminal and cervical afferent pathways in animals and suggest that the modulation of this pathway is of potential benefit in primary headache disorders.

Long-Term Outcome in Occipital Nerve Stimulation Patients With Medically Intractable Primary Headache Disorders

2012 ◽  
Vol 16 (6) ◽  
pp. 557-564 ◽  
Author(s):  
Ann Chang Brewer ◽  
Terrence L. Trentman ◽  
Michael G. Ivancic ◽  
Bert B. Vargas ◽  
Alanna M. Rebecca ◽  
...  
Keyword(s):  
Nerve Stimulation ◽  
Primary Headache ◽  
Headache Disorders ◽  
Occipital Nerve Stimulation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Occipital Nerve ◽  
Primary Headache Disorders

Headache

2018 ◽  
Author(s):  
Benjamin W Friedman
Keyword(s):  
Differential Diagnosis ◽  
Clinical Characteristics ◽  
Sinus Thrombosis ◽  
International Headache Society ◽  
Primary Headache ◽  
Primary Headaches ◽  
Key Words Migraine ◽  
Secondary Headaches ◽  
Primary Headache Disorders ◽  
Greater Occipital Nerve

Headaches are one of the most common complaints of patients seen by emergency physicians. They can be classified as primary headaches, which have no identifiable underlying cause, and secondary headaches, which are classified according to their cause. The majority of headaches are benign in origin, and most patients with headache can be treated successfully in the emergency department and discharged home; however, some have potentially life-threatening causes, and consideration of a broad differential diagnosis for all patients is essential. This review covers the primary headache disorders, pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes. The figure shows areas of the brain sensitive to pain. Tables review differential diagnosis of headache, International Headache Society primary headache criteria, clinical characteristics of secondary headaches, high-risk clinical characteristics among patients with a headache peaking in intensity within 1 hour, drugs associated with headache, and parenteral treatment of acute migraine. This review contains 1 figure, 9 tables, and 58 references. Key words: migraine, calcitonin gene related peptide, greater occipital nerve block, venous sinus thrombosis, reversible cerebral vasoconstriction syndrome, Ottawa, subarachnoid, cluster headache, trigeminal autonomic cephalalgias, post-traumatic headache

scholarly journals Use of traditional medicine for primary headache disorders in Kuwait

2018 ◽  
Vol 19 (1) ◽  
Author(s):  
Jasem Y. Al-Hashel ◽  
Samar Farouk Ahmed ◽  
Fatemah J Alshawaf ◽  
Raed Alroughani
Keyword(s):  
Traditional Medicine ◽  
Primary Headache ◽  
Headache Disorders ◽  
Primary Headache Disorders
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